Provider Demographics
NPI:1447463153
Name:DEAR HEARTS RESPITE AND PCA SERVICES, INC.
Entity type:Organization
Organization Name:DEAR HEARTS RESPITE AND PCA SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-239-2885
Mailing Address - Street 1:113 KINGS WAY
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1403
Mailing Address - Country:US
Mailing Address - Phone:504-821-5220
Mailing Address - Fax:504-821-6330
Practice Address - Street 1:113 KINGS WAY
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1403
Practice Address - Country:US
Practice Address - Phone:504-821-5220
Practice Address - Fax:504-821-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA6879251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1170585Medicaid